ABSTRACT

"Publication in clinical chemistry, the assistant resident physician continued, was becoming the goal of the "scientific practitioner". The Mayo brothers, William James and Charles Horace were concerned about the general tendency by physicians to abandon the old methods and to rely too much upon laboratory analysis and too little on patient history and clinical examination. They warned against the danger of "laboratory diagnosis," and insisted that the laboratory findings only be a supplement to the clinician's personal study of the patient. The doctor whose diagnosis and follow-up depended heavily on technology could believe that he was practicing scientific medicine. The key components of managed care are cost containment, increased efficiency, decreased utilization of services, diagnostic effectiveness, and outcomes assessment and analysis. The collective frustration by the hospital community and the public over the escalation of healthcare costs has been one of the factors in the rapid emergence of managed care.